What is OHIP billing code R774?

R774 is "Mitral valve reconstruction - complex", an OHIP Radiology code from the Ontario Schedule of Benefits (Physician Services).

How much does R774 pay?

The current OHIP fee for R774 is $2058.20, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill R774 to OHIP?

R774 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates R774 claims against the Schedule of Benefits rules before submission.

What codes are related to R774?

Codes related to R774 in the Schedule of Benefits include R773.

All codes

R774

R774 – Mitral valve reconstruction - complex

OHIP Radiology Code — CARDIOVASCULAR SURGICAL PROCEDURES · Schedule of Benefits

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Complex mitral valve reconstruction is a surgical procedure that involves repairing the mitral valve. This service, identified by R774, includes annuloplasty (reshaping the valve's ring) and repair of both the anterior and posterior leaflets of the mitral valve. The fee for this service can be billed with suffixes for the surgeon (A), assistant (B), and anaesthetist (C), with the latter two being calculated based on a system of base and time units.

When to Use

Use R774 when performing a comprehensive mitral valve repair that includes both annuloplasty and the reconstruction of both the anterior and posterior leaflets.
Select R774 over R773 (Mitral valve reconstruction - simple) when the surgical complexity exceeds a single-leaflet repair or simple annuloplasty, specifically requiring multi-leaflet intervention.

Common Pitfalls

Billing R774 alongside other valve procedures without applying the 85% reduction rule for additional valves as per the Schedule of Benefits.
Failing to document the specific complexity of the leaflet reconstruction, which is necessary to justify the 'complex' designation over simpler repair codes.
Incorrectly applying trauma premiums (E420) when the procedure is elective, as R774 is typically a planned cardiac intervention.

Billing Tips

Ensure the anaesthesiologist includes the appropriate ASA status add-on (E022C, E017C, or E016C) to maximize the anaesthetic unit value for this complex procedure.
If the procedure is performed on a pediatric patient, ensure the relevant age premium (e.g., AGE_PREMIUM_5Y_TO_16Y) is applied to the surgical fee to reflect the increased complexity of pediatric cardiac repair.

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Provider Fee$2,058.20

Surgical Assistant Fee$225.18

Anaesthetist Fee$433.72

Non-Anaesthetist Fee$433.72

Effective: April 1, 2025

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